Intensive Care Medicine (ICM) encompasses the investigation, diagnosis and treatment of acute illness with the provision of organ support. Non-technical aspects of patient care including patient safety, ethics and end-of-life planning are also a hugely important part of the role. The consultants and trainees work mainly in the Intensive Care Unit but will be involved with the care of critically ill patients anywhere in the hospital.
The speciality has seen much change in the past few years. In 2010 the Faculty of Intensive Care Medicine was founded. The Faculty is the professional and statutory body for the speciality of Intensive Care Medicine. The entry to ICM used to be via a parent speciality. However in 2011 the standalone CCT in Intensive Care Medicine curriculum was approved by the GMC and saw its first trainees appointed in 2012. This has allowed trainees to gain a single CCT in ICM. Trainees can also dual train, coupling an ICM training number with a training number in anaesthetics, emergency medicine, acute medicine, renal medicine or respiratory medicine.
The training programme now has a compulsory exam to be passed before starting the last year of training. The FFICM exam rewards the candidate with Fellowship of the Faculty of Intensive Care Medicine.
Advantages and Disadvantages of a career in Critical Care Medicine
- Exciting stimulating, and varied work
- Work closely with colleagues from many specialities
- Opportunity to lead multidisciplinary team
- Dynamic, rapidly changing patient base
- Opportunity to make a difference to patients and relatives
- Units generally well resourced with staff and equipment
- Brings physiology and pharmacology to life
- Good career progression
- Antisocial working hours
- Work can be emotionally draining
- Limited opportunities for private practice
- Resources often stretched, forcing difficult decisions about priorities of care
Intensive Care Medicine does not have its own core training but instead accepts trainees from the following programmes:
- Acute Care Common Stem (ACCS)
- Core Anaesthetic Training (CAT)
- Core Medical Training (CMT)
- Defined Route of Entry into Emergency Medicine (DRE-EM)
NB: Core Medical Training will be replaced with Internal Medicine training from August 2019, which will include 3 months of direct training in ICM.
In addition to completion of one of the identified ICM core training programmes you will need to have completed one of the following exams, as relevant to that core programme:
- FRCA (Primary)
- MRCP UK (Full)
- FRCEM Primary (or MRCEM Part A after August 2012) AND FRCEM Intermediate SAQ (or MRCEM Part B after August 2012) AND FRCEM Intermediate SJP OR MRCEM obtained prior to August 2018
The training programme
Both single and dual trainees have to progress through stages 1 to 3 in order to attain CCT.
Stage 1 training
Stage 1 training includes the completion of one of the defined core programmes and the first two years of Higher Specialist Training (ST3-4). These two years are aimed at developing the core competencies that were not covered in your core training programme, in addition to extending ICM experience. For example trainees from a core medical background will gain experience in anaesthetics and those from an anaesthetic background will undertake basic medical training.
Stage 2 training
Stage 2 training runs from ST5 to ST6. During these years you will gain experience of sub- specialty ICM including cardiothoracic, neurosciences and paediatric ICM in addition to further general ICM experience.
Stage 2 training differs depending on whether the trainee is working towards a single or dual CCT. For those on the single CCT programme Stage 2 training includes a ‘Special Skills’ year. This year is aimed at allowing you to develop an area of special interest: examples include research, quality improvement, pre-hospital medicine, education or echocardiography.
Dual trainees will spend their Special Skills year their partner specialty.
During Stage 2 training you will be required to pass the Final FFICM examination in order to progress to the final year.
Stage 3 training
Stage 3 is the final year of training which is spent exclusively in ICM regardless of whether the trainee is on a single or dual training programme. This year is aimed at developing high-level clinical and non-clinical skills in the run up to becoming a consultant.
Good communication skills, caring and supportive of patients and their relatives. Able to work in and learn from a multidisciplinary critical care environment. Courteous, meticulous and hardworking. Good physical health; ability and enthusiasm for medical research and an enquiring mind.
Training Programme Director ICM West Midlands
Dr Brian Pouchet
Consultant in ICM and Anaesthetics
Queen Elizabeth Hospital
Regional Advisor- West Midlands
Dr Mamta Patel
Consultant in Anaesthesia & Intensive Care Medicine
Bordesley Green East
West Midlands ICM trainee leads
Laura Kocierz – Laura.K@doctors.org.uk
Day in the Life of ITU registrar
The day starts at 0800 with handover. The night team brief the day team on the events of the night to ensure continuity of care. This is followed by a consultant-led ward round, with all patients receiving a thorough systems review. After this the day varies according to patient case-mix. Typically trainees will be performing procedures, teaching and supervising SHO’s, reviewing referrals from A&E or the wards and updating patients’ families on progress.
There is usually time to work on audits, receive teaching and complete workplace-based assessments. The patient-case mix and constantly evolving nature of critical illness allow for lots of variety and interest. Our patients are visited by a variety of medical and allied-health care professionals throughout their stay and a key role of the intensivist is to bring these inputs together to ensure that care is delivered in a cohesive manner.
Page Updated: 28 February 2019